{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:02:51Z","timestamp":1771473771431,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Psychiatry and Medical Psychology, University of Navarra Clinic, Pamplona, Spain"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Children and adolescents with subthreshold manic symptoms not meeting full DSM criteria for bipolar I or II disorder (BP-I or BP-II) are classified as unspecified bipolar disorder (formerly bipolar not otherwise specified: BP-NOS). Factors associated with transition from BP-II or NOS to BP-I may predict the progression of the disorder. Our objective is to analyze factors associated with transition to BP-I in a Spanish sample of youth with BP-NOS or BP-II. Methods: We included all youth diagnosed with BP before 18 years of age presenting to our clinic (October 1999\u2013December 2014). We assessed clinical factors that may predict transition to BP I with a logistic regression and a multivariable model for data analysis. Results: A total of 72 patients with BP, mean (SD) age 14.5 (10.5\u201316.0) years, were followed for a median period of 3.9 years. In total, 95.8% of patients retained the BP diagnosis, but they changed type. Baseline BP-I % was 37.5%, and 62.5% at endpoint. BP-NOS decreased from baseline 54.2% to 25% at endpoint. The % of BP-II was 8.3% in both time points, but they were not the same individual patients, as some transitioned from BP-II to BP-I and some BP-NOS changed to BP-II. BP-NOS was stable in 46.1% of patients, but 38.5% transitioned to BP-I over time. Psychotic symptoms during prior depressive episodes (MDD) increased the risk of transition to BP-I by 11-fold. Each individual symptom of mania increased the risk of transition to BP-I by 1.41. Conclusions: BP-NOS was stable in 46.1% of patients, but 38.5% transitioned to BP-I over time. Psychotic symptoms during prior MDD episodes increased the risk of transition from BP-NOS to BP-I.<\/jats:p>","DOI":"10.3390\/jcm13195656","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T08:56:06Z","timestamp":1727168166000},"page":"5656","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Transition from Child and Adolescent Bipolar Not Otherwise Specified to Bipolar I Disorder, a Longitudinal 3.9-Year Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Mar\u00eda","family":"Ribeiro-Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Navarra Medical Complex, Navarra Health System (Spanish National Health System), 31008 Pamplona, Navarra, Spain"},{"name":"IdiSNA: Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-9351","authenticated-orcid":false,"given":"Azucena","family":"D\u00edez-Su\u00e1rez","sequence":"additional","affiliation":[{"name":"IdiSNA: Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain"},{"name":"Child and Adolescent Psychiatry Unit, Department of Psychiatry & Medical Psychology, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiki D.","family":"Chang","sequence":"additional","affiliation":[{"name":"Private Practice, Palo Alto, CA 94306, USA"},{"name":"Louis A. Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-0772","authenticated-orcid":false,"given":"Cesar A.","family":"Soutullo","sequence":"additional","affiliation":[{"name":"Louis A. Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). DSM 5 Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. 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